Kathleen, really? I didn’t think you were old enough to be measuring in “donkey years”!

OK, so I’m going to leap to the conclusion that she didn’t have any implants or anything else going on, as you did not mention that. Stepping completely outside of my scope of practice here, I’m wondering if it might be a galactocele. A galactocele (also sometimes called “lactocele”) is a cyst. Any cyst would be filled with a fluid, fatty, or solid substance. In this case, milk. It’s tempting to think about an abscess, since she has just had a bout of mastitis. But you didn’t mention inflammation, and an abscess is generally very inflamed. And, sounds like the antibiotics didn’t do any good, and you’d think the abx would have worked on an abscess. Because this sounds like more of  hardened mass, I’d be wondering about a galactocele. 

That being said, I didn’t go to medical school, am not authorized to diagnose, and definitely can’t diagnose from 500 miles away!  Perhaps she is open to getting a second opinion, or even revisiting the doctor she saw? The doctor did not do a needle aspiration? Seems like ultrasound alone is not going to be very helpful here. 

Someone asked about some resources.  Here are some that may or may not be helpful, depending on what else may or may not be part of the presentation. Yes, I realize that many people have no interest in an article that is more than 5 years old, but honestly, it may be another few decades before we have any more “new” or “useful” information on this condition. As one who has been in this for “donkey years” you will surely agree that this thing is fairly uncommon so digging up some old articles might be helpful. 
1.         Taylor D, Kulawansa ST, McCallum DD, Saunders C. Peri-implant galactocele following vacuum-assisted core biopsy of the breast: a cautionary tale. BMJ case reports.2013.

2.         Harper JG, Daniel JR, McLean JN, Nahai F. Postaugmentation galactocele. Plastic and reconstructive surgery. May 2013;131(5):862e-863e.

3.         Poiana C, Chirita C, Carsote M, Hortopan D, Goldstein A. Galactocele and prolactinoma--a pathogenic association? Maturitas. Jan 20 2009;62(1):98-102.

4.         Chun YS, Taghinia A. Hyperprolactinemia and galactocele formation after augmentation mammoplasty. Ann Plast Surg. Feb 2009;62(2):122-123.

5.         Whang IY, Lee J, Kim KT. Galactocele as a changing axillary lump in a pregnant woman. Arch Gynecol Obstet. Oct 2007;276(4):379-382.

6.         Ghosh K, Morton MJ, Whaley DH, Sterioff S. Infected galactocele: a perplexing problem. Breast J. Mar-Apr 2004;10(2):159.

7.         Zimman OA. About images with breast implants and galactocele. Plastic and reconstructive surgery. Dec 2003;112(7):1951-1952; author reply 1952-1953.

8.         Auvichayapat P, Auvichayapat N, Tong-un T, Thinkhamrop B, Vachirodom D, Uttravichien T. A controlled trial of a new treatment for galactocele. J Med Assoc Thai. Mar 2003;86(3):257-261.

9.         Raso DS, Greene WB, Silverman JF. Crystallizing galactocele. A case report. Acta Cytol. 1997 May-Jun 1997;41(3):863-870.

10.       Bevin TH, Pearson CK. Breastfeeding difficulties and a breast abscess associated with a galactocele: a case report. J Hum Lact. 1993;9(3):177-178.



—Marie Biancuzzo RN MS IBCLC http://breastfeedingoutlook.com 	

> On May 6, 2015, at 7:57 AM, Kathleen Bruce <[log in to unmask]> wrote:
> stumped. I've been an IBCLC since 1993 and have been working with bf
> mothers in my area in Vermont, and over the world as an online LC, and here
> as the Lactnet dreamer upper for donkey years.
>  
> Mother has had a few bouts of mastitis, one lately that stemmed from a
> 2x2x2cm lump close to her chest wall. 
> 
> Mother very concerned. Saw breast surgeon, who did not have vast knowledge
> of the lactating breast, but who did ultrasound it. She has a mass of
> hardened milk, he thought. No needle biopsy. Did not appear to be cancer,
> or an abscess.  Has anyone heard of this large an area of hardened milk?
> 
> 
> 


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